Corticosteroid fear in parents of children with atopic dermatitis.

Background: Topical corticosteroids (TCS) are the mainstay of therapy for paediatric atopic dermatitis (AD). The use of TCS is often met with fear by parents. Assessing this parental TCS fear in clinical practice is still lacking. Aim: The aim was to assess parental fear and beliefs about TCS. Furthermore, we evaluated the quality of life (QoL) of the family and the disease severity of affected children. Methods: We conducted an observational study with a cross-sectional design. Inclusion criteria were children aged 0 to 5 years with a diagnosis of AD and outpatient treatment. The outcome measures were parental fears and beliefs about TCS, assessed with the "Topical Corticosteroid Phobia Score" (TOPICOP), parental QoL evaluated with the "Family Dermatology Life Quality Index", and disease severity, assessed with the "Scoring atopic dermatitis" (SCORAD). Descriptive statistic was used to analyse the data. Results: The current study found that in 40 affected children, 25 (62.5%), suffered from mild AD, 12 (30%) children had moderate AD, and 3 (7.5%) children had severe AD. TCS fear among parents was notable (mean TOPICOP score 18.1, standard deviation (SD) 7.1). The QoL was moderately affected (mean FDLQI score 6.5, SD 2.8). Conclusions: Our study indicates that fear of TCS is prevalent. Furthermore, our data indicate that severity of TCS fear varies markedly between parents, ranging from parents with almost no fear to parents with high levels of fear. For effective education in clinical practice, the individual level of fear must be recognized and taken into account.

Mental health and sleep quality of low-income mothers of one-year-olds during the COVID-19 pandemic.

The COVID-19 pandemic and subsequent social restrictions created an unprecedented context for families raising young children. Although studies have documented detrimental effects of the pandemic on maternal well-being, less is known about how the pandemic specifically impacted low-income mothers. We examined depression, anxiety, and sleep quality among low-income mothers of one-year-olds during the early months of the pandemic using data from the Baby's First Years study. Focusing on the control group (n = 547), we compared mothers interviewed before March 14th, 2020 (n = 342) to mothers interviewed between March 14th and June 30th, 2020 (n = 205) to determine whether the pandemic was associated with differences in mental health and sleep quality. Mothers were recruited from four cities in the United States, and most of the sample identified as Hispanic (42.2%) or Black, non-Hispanic (38.6%). We found that mothers interviewed during the pandemic reported better mental health and sleep quality. While we cannot speak to longer-term impacts of the pandemic, it is possible low-income mothers experienced relief from daily stressors during the initial shelter-in-place orders, which may have led to improvements in well-being. These results have implications for understanding how complex life stressors influence mental health and sleep quality among low-income mothers raising young children.

La pandemia del COVID-19 y las subsecuentes restricciones sociales crearon un contexto sin precedentes para las familias que estaban criando niños pequeños. Aunque los estudios han documentado los efectos perjudiciales de la pandemia sobre el bienestar materno, menos se conoce acerca de cómo la pandemia específicamente tuvo un impacto sobre madres de bajos recursos económicos. Examinamos la depresión, ansiedad y calidad del sueño entre madres de bajos recursos económicos de niños de un año de edad durante los primeros meses de la pandemia usando datos del estudio Primeros Años del Bebé. Enfocándonos en el grupo de control (n = 547), comparamos las madres entrevistadas antes del 14 de marzo de 2020 (n = 342) con madres entrevistadas entre el 14 de marzo y el 30 de junio de 2020 (n = 205) para determinar si la pandemia se asociaba con diferencias en salud mental y calidad del sueño. A las madres se les reclutó en cuatro ciudades de Estados Unidos y la mayor parte del grupo muestra se identificaron como Hispanas (42.2%) o Negras no Hispanas (38.6%). Encontramos que las madres entrevistadas durante la pandemia reportaron mejor salud mental y calidad del sueño. A pesar de que no podemos hablar sobre el impacto a largo plazo de la pandemia, es posible que las madres de bajos recursos económicos experimentaran alivio en los factores diarios de estrés durante el inicial mandato de quedarse en su casa, lo cual pudiera haber llevado a mejoras en el bienestar. Estos resultados tienen implicaciones para comprender cómo los complejos factores de estrés influyen en la salud mental y la calidad del sueño entre madres de bajos recursos económicos que crían a niños pequeños.

La pandémie du COVID-19 et les restrictions sociales qui en ont découlé ont créé un contexte sans précédent pour les familles élevant de jeunes enfants. Bien que des études aient documenté des effets préjudiciables de la pandémie sur le bien-être maternel, on en sait moins sur la manière dont la pandémie a spécifiquement impacté les mères de milieux défavorisés. Nous avons examiné la dépression, l'anxiété, et la qualité du sommeil chez des mères de milieux défavorisés avec un enfant d'un an durant les premiers mois de la pandémie, en utilisant des données de l'étude Baby's First Years. Nous concentrant sur le groupe de contrôle (n = 547), nous avons comparé des mères interviewées avant le 14 mars 2020 (n = 342) à des mères interviewées entre le 14 mars et le 30 juin 2020 (n = 205) afin de déterminer si la pandémie était liée à des différences en santé mentale et en qualité de sommeil. Les mères ont été recrutées dans quatre villes des Etats-Unis et la plupart de l'échantillon s'identifiait comme Hispanique (42,2%) ou Noires, non hispaniques (38,6%). Nous avons trouvé que les mères interviewées Durant la pandémie faisaient état d'une meilleure santé mentale et d'une meilleure qualité de sommeil. Bien que nous ne puissions pas parler des impacts de la pandémie à long terme, il est possible que les mères de milieux défavorisés aient fait l'expérience d'un soulagement des facteurs de stress quotidiens durant la période initiale de confinement, ce qui pourrait avoir mené à des améliorations dans le bien-être. Ces résultats ont des implications pour la compréhension de la manière dont des facteurs de stress complexes influencent la santé mentale et la qualité du sommeil chez les mères de milieux défavorisés élevant de jeunes enfants.

[The Therapeutic Potential of Prebiotics and Probiotics in Child and Adolescent Psychiatric Disorders]. / Zum therapeutischen Potenzial der Gabe von Präbiotika und Probiotika bei kinder- und jugendpsychiatrischen Erkrankungen.

The Therapeutic Potential of Prebiotics and Probiotics in Child and Adolescent Psychiatric Disorders Abstract: This short review summarizes the literature available on therapeutic interventions with prebiotics and probiotics and their potential use in psychiatric disorders in childhood, adolescence, and adulthood. Most studies of children and adolescents are done on ADHD and autism spectrum disorders, whereas single reports exist largely on positive effects on cognitive symptoms and quality of life. Initial studies regarding anorexia nervosa point to a potential effect of weight gain and reduction of gastrointestinal symptoms. To date, the effects of prebiotics and probiotics in depression, bipolar disorder, anxiety disorders, and schizophrenia have been mainly investigated in adults. The best reported evidence exists for depression, whereas the effects on depressive symptomatology are small. Positive effects are seen on gastrointestinal symptoms in these disorders. Given these positive effects, the mixed literature reports may result from very heterogeneous study designs. Nevertheless, the high potential of prebiotics and probiotics may be seen for minors with mental health problems. Further studies that include child and adolescent psychiatric populations and reflect the complexity of the gut-brain axis are urgently needed.

Death Anxiety in the Context of Religion, Personality and Life Meanings.

Previous studies on the context between death anxiety and religion do not provide any clear evidence regarding "anxiety buffer" function. In this explorative study, death anxiety and attitude to death were determined in the context of mood, personality and meaning of life among groups of Muslims (n = 60) and Christian Protestants (n = 60). Death anxiety and attitude to death were assessed using the Bochum questionnaire for recording death anxiety and attitudes to death. Death anxiety was mild to moderate in our healthy Participants of Muslim and Christian faith. Attitude towards death was therefore much more pronounced among Muslim members than Christians. The influence of religious beliefs on the fear of death does not appear to be direct and linear. Sources that provide meaning in life and emotional stability can contribute to a reduction in death anxiety and a less problematic attitude towards death.

In time, we will simply disappear: Racial demographic shift undermines privileged group members' support for marginalized social groups via collective angst.

The racial demographic shift occurring in many Western countries provides a unique context to study the reactions of a high-power group (White people) to the potential loss of their privileged position in society. Three experiments (N = 77, N = 302, N = 555) conducted in Canada, the US, and the UK showed that White people who are reminded about the ongoing demographic changes and who see race relations as a zero-sum game whereby any gains by minorities must come at the expense of the majority, experience stronger collective angst and, to a lesser extent, fear (but not anger). In turn, collective angst, but not the other negative group-based emotions, fuels their motivation to protect the existing intergroup hierarchy by withdrawing support for progressive social movements and increases anti-immigration sentiments. Downregulating the existential threat experienced by White majorities in the face of a racial demographic shift may be one way to reduce acrimonious behavioral intentions aimed at preserving their place in the social hierarchy.

The role of temperament and parenting on anxiety problems among toddlers: Moderating role of parenting and mediating role of attachment.

Anxiety problems are seen as early as 1-2 years of age. Among others, parenting and child temperament are considered as the most important factors affecting anxiety in early childhood. In the current study, the unique roles of parenting (maternal overprotectiveness and warmth) and temperament (behavioral inhibition and negative emotionality), parenting-temperament interactions, and mediating role of ambivalent attachment between behavioral inhibition and anxiety were investigated. One-hundred mother-child (18-36-month-old) dyads participated in this study. Children's anxiety and temperament were measured through mother-reported scales, attachment was measured by observation via home visits, and parenting dimensions were measured via both mother-reported scales and observation. The results revealed that behavioral inhibition and overprotectiveness were positively associated with toddlers' anxiety, whereas there were no significant direct associations of negative emotionality and warmth with anxiety. However, the interaction between behavioral inhibition and warmth predicted toddler's anxiety; that is, if behaviorally inhibited children had mothers who were low on warmth, those children were more likely to exhibit anxiety symptoms compared to children with low behavioral inhibition, whereas anxiety levels did not change for children of warm mothers. Ambivalent attachment mediated the relationship between behavioral inhibition and anxiety. The nature of parent-child interactions is discussed based on toddlerhood anxiety.

Los problemas de ansiedad ya se ven a la temprana edad de 1-2 años. Entre otros, se considera la crianza y el temperamento del niño como los más importantes factores que afectan la ansiedad en la temprana niñez. En el presente estudio se investigaron los roles distintivos de crianza (la sobreprotección y calidez maternas) y temperamento (inhibición de conducta y emocionalidad negativa), las interacciones crianza-temperamento y el rol mediador de la afectividad ambivalente entre inhibición de conducta y ansiedad. Cien díadas madre-niño (18-36 meses de edad) participaron en este estudio. Se midió la ansiedad y el temperamento de los niños por medio de escalas que las madres reportaron, se midió la afectividad por medio de observaciones en visitas a casa, y las dimensiones de crianza se midieron por medio tanto de escalas que las madres reportaron como la observación. Los resultados revelaron que la inhibición de conducta y la sobreprotección se asociaban positivamente con la ansiedad de los pequeños niños, mientras que no se dieron significativas asociaciones directas de la emocionalidad negativa y la calidez con la ansiedad. Sin embargo, la interacción entre la inhibición de conducta y la calidez predijeron la ansiedad de los niños pequeñitos; es decir, si los niños inhibidos en cuanto a conducta tenían madres que estaban a nivel bajo en cuanto a calidez, esos niños estaban más propensos a exhibir síntomas de ansiedad comparados con niños con bajos niveles de inhibición de conducta, mientras que los niveles de ansiedad no cambiaron para niños con madres de cálida acogida. La afectividad ambivalente medió la relación entre la inhibición de conducta y la ansiedad. Se discute la naturaleza de las interacciones progenitor-niño con base en la ansiedad en la primera infancia.

On voit des problèmes d'anxiété aussi tôt qu'à 1-2 ans d'âge. Entre plein d'autres facteurs, le parentage et le tempérament de l'enfant sont estimés être les facteurs les plus importants qui affectent l'anxiété dans la petite enfance. Dans cette étude les rôles uniques du parentage (surprotection maternelle et chaleur maternelle) et le tempérament (inhibition comportementale et émotivité négative), les interactions parentage-tempérament, le rôle médiateur de l'attachement ambivalent entre l'inhibition comportementale et l'anxiété ont fait l'objet des recherches. Cent dyades mère-enfant (18-36 mois d'âge) ont participé à cette étude. L'anxiété et le tempérament des enfants ont été mesurés au travers d'échelles rapportées par la mère et l'attachement a été mesuré par observation au travers de visites à domicile. Les dimensions parentales ont été mesurées au travers d'à la fois les échelles rapportées par la mère et l'observation. Les résultats ont révélé que l'inhibition comportementale et la surprotection sont liées de manière positive à l'anxiété du petit enfant, alors qu'il n'y a pas de lien direct avec l'anxiété pour l'émotivité négative et la chaleur. Cependant l'interaction entre l'inhibition comportementale et la chaleur a prédit l'anxiété du petit enfant. En fait, si les enfants inhibés du point de vue comportemental avaient des mères n'étant pas chaleureuses, ces enfants avaient plus tendance à faire preuve de symptômes d'anxiété que les enfants avec une inhibition comportementale plus basse, alors que les niveaux d'anxiété n'ont pas changé pour les enfants avec des mères chaleureuses. L'attachement ambivalent a médiatisé la relation entre l'inhibition comportementale et l'anxiété. La nature des interactions parent-enfant est discutée basée sur l'anxiété du petit enfant.

[Examination of the Multidimensional Anxiety Inventory for Children and Adolescents (MAICA) in Clinical Samples]. / Überprüfung des Mehrdimensionalen Angstinventars für Kinder und Jugendliche (MAI-KJ) an klinischen Stichproben.

Questionnaires such as the Multidimensional Anxiety Inventory for Children and Adolescents (MAICA) provide a diagnostic approach to alert for anxiety- or depression-related problems. The aim is to examine the MAICA within two clinical samples.We first investigated whether children having anxiety- or depression-related problems (n = 94) scored higher on anxiety (i.e., emotionality and worry) and depression (i.e., dysthymia and low joy) than a non-clinical control group (n = 282). Then, we contrasted a clinical sample with other mental disorders unrelated to anxiety or depression (n = 45) with another non-clinical control group (n = 135). Across all scales of the MAICA, children with anxiety- or depression-related problems showed less favourable values than the non-clinical control group (d = 0.34 to 0.54 for anxiety, 0.55 to 0.68 for depression). Children with other mental problems showed no differences in either the anxiety or depression scales. For the use as a screening instrument, preliminary cutoff scores for identifying anxiety- or depression-related problems with the MAICA are given.

Maternal depressive symptoms, poverty, and young motherhood increase the odds of early depressive and anxiety disorders for children born prematurely.

Children born preterm, compared to term, are at risk for behavioral problems. However, the prevalence and predictors of internalizing disorders among children born preterm are unclear. The purpose of this study was to identify the prevalence of depressive and anxiety disorders at 2 years of age among children born preterm and determine the extent to which poverty, maternal depressive symptoms, or young motherhood increase the likelihood of these disorders. Mothers and their infants (N = 105) were recruited from two neonatal intensive care units affiliated with a major U.S. university. A sociodemographic questionnaire, the Patient Health Questionnaire-9, and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition scale scores from the Preschool Child Behavior Checklist were used to measure primary variables. We examined mothers' family satisfaction and quality of caregiving as well as children's degree of prematurity, morbidity, gender, cognitive functioning, and motor function as covariates. Fifteen percent of children met criteria for an anxiety disorder and another 15% for depression. Maternal depressive symptoms increased the odds of children developing both anxiety and depression, whereas young motherhood was associated with child anxiety and poverty with child depression. Results indicate the need for mental health assessment of children born preterm during their first 2 years of life and the importance of early therapeutic and tangible support to vulnerable mothers and children.

Los niños nacidos prematuramente, comparados con los no prematuros, están bajo riesgo de problemas de comportamiento. Sin embargo, la prevalencia y factores de predicción de la internalización de los trastornos entre niños nacidos prematuramente no están claras. El propósito de este estudio fue identificar la prevalencia de trastornos depresivos y de ansiedad a los 2 años de edad entre niños nacidos prematuramente y determinar hasta dónde la pobreza, los síntomas depresivos maternos o la maternidad joven aumentan la probabilidad de estos trastornos. A las madres y sus infantes (N = 105) se les reclutó de 2 unidades de cuidados intensivos neonatales afiliadas con una importante universidad de los Estados Unidos. Un cuestionario sociodemográfico, el PHQ-9 y los puntajes de la escala DSM-5 de la Lista de Verificación de la Conducta Prescolar del Niño se usaron para medir las variables primarias. Examinamos la satisfacción familiar y la calidad de la prestación del cuidado de las madres, así como el grado de prematuridad, la morbilidad, el género, el funcionamiento cognitivo, y la función motora de los niños como covariables. Quince por ciento de los niños cumplía los criterios para un trastorno de ansiedad y otro 15% para depresión. Los síntomas depresivos maternos aumentaron las posibilidades de que los niños desarrollaran tanto ansiedad como depresión, mientras que la maternidad joven se asoció con la ansiedad del niño y la pobreza con la depresión del niño. Los resultados indican la necesidad de evaluar la salud mental de niños nacidos prematuramente durante sus dos primeros años de vida y la importancia del temprano apoyo terapéutico y tangible a las madres y niños vulnerables.

Les enfants nés prématurés, comparés aux enfants né à terme, sont à risque de problèmes de comportement. Cependant, la prévalence et les prédicteurs de troubles d'intériorisation chez les enfants nés avant-terme ne sont pas claires. Le but de cette étude était d'identifier la prévalence des troubles dépressifs et des troubles d'anxiété à l'âge de 2 ans chez des enfants nés avant terme et de déterminer dans quelle mesure la pauvreté, les symptômes dépressifs maternels ou le statue de jeune mère augmente la probablbilité de ces troubles. Des mères et leurs nourrissons (N = 105) ont été recrutées dans deux services de réanimation néonatale dans une CHU américaine importante. Un questionnaie sociodémographique, le PHQ-9 et les scores de l'échelle DSM-5 de la Checklist de Comportement de l'Enfant d'Âge Préscolaire ont été utilisés pour mesurer les variables primaires. Nous avons examiné la satisfaction familiale des mères et la qualité du mode de soin ainsi que le degré de prématurité des enfants, leur morbidité, le genre, le fonctionnement cognitif et la fonction motrice comme covariants. Quinze pourcent des enfants ont rempli les critères pour un trouble de l'anxiété et un autre 15% pour la dépression. Les symptômes dépressifs maternels ont augmenté les chances que les enfants développent à la fois de l'anxiété et de la dépression, alors que le fait d'être une jeune mère était lié à l'anxiété de l'enfant et la pauvreté avec la dépression de l'enfant. Les résultats indiquent le besoin d'une évaluation de la santé mentale des enfants nés avant terme durant les deux premières années de leur vie et l'importance d'un soutien thérapeutique précoce et tangile pour les mères et les enfants vulnérables.

The developmental cascade of early parenting, emergence of executive functioning, and emotional symptoms across childhood.

Many studies focus on proximal associations between parental sensitivity and emotional well-being in early childhood, with less data examining how parenting in infancy predicts children's emotional trajectories across childhood, in particular negative emotional symptoms of anxiety and depression. Thus, this study utilized data from The Family Life Project (N = 1015), a prospective study of child development in rural poverty, and assessed whether sensitive parenting in the first 4 years of life predicted child internalizing emotional symptoms (i.e., anxiety and depression) from kindergarten to fifth grade and whether early child executive functioning mediated this relationship. Path models indicated that observation of sensitive parenting predicted a decrease in teachers' report of child negative emotional symptoms over time and predicted fewer negative emotional symptoms in fifth grade. Moreover, though executive functioning performance did not mediate change in symptoms over time, executive functioning did mediate the relationship between sensitive parenting and fifth-grade symptoms, suggesting that executive functioning is one mechanism by which early sensitive parenting buffers long-term emotional development. Findings highlight the importance of early parenting and executive functioning in development of anxiety and depression symptoms and suggests potential targets for transdiagnostic intervention.

Muchos estudios se enfocan en asociaciones proximales entre la sensibilidad del progenitor y el bienestar emocional en la temprana niñez, aunque una menor información examina cómo la crianza en la infancia predice las trayectorias emocionales de los niños a lo largo de la niñez, particularmente los síntomas emocionales de ansiedad y depresión. Por tanto, este estudio utilizó datos de [BLINDED FOR REVIEW] (N = 1,015), un estudio en prospecto del desarrollo del niño en la pobreza rural, y evaluó si la crianza sensible en los primeros 4 años de vida predijo los síntomas emocionales de internalización en el niño (v.g. ansiedad y depresión) a partir del kínder hasta el quinto grado y si el temprano funcionamiento ejecutivo del niño mediaba esta relación. Los modelos de trayecto indicaron que la observación de la crianza sensible predijo una baja en los reportes de los maestros sobre síntomas emocionales negativos en el niño a lo largo del tiempo y predijo menos síntomas emocionales negativos en el quinto grado. Es más, a pesar de que el rendimiento del funcionamiento ejecutivo no medió el cambio en los síntomas a lo largo del tiempo, el funcionamiento ejecutivo sí medió la relación entre la crianza sensible y los síntomas en el quinto grado, lo cual sugiere que el funcionamiento ejecutivo es un mecanismo por medio del cual la temprana crianza sensible amortigua el desarrollo emocional a largo plazo. Los resultados subrayan la importancia de la crianza temprana y el funcionamiento ejecutivo en el desarrollo de los síntomas de ansiedad y depresión y sugiere metas probables para la intervención de transdiagnosis.

Beaucoup d'études portent sur les liens proximaux entre la sensibilité parentale et le bien-être émotionnel dans la petite enfance, avec moins de données examinant comment le parentage dans la petite enfance prédit les trajectoires émotionnelles des enfants durant l'enfance, en particulier les symptômes émotionnels négatifs d'anxiété et de dépression. Donc, cette étude a utilisé des données du Project de Vie Familiale (en anglais Family Life Project) (N = 1015), une étude prospective du développement de l'enfant en pauvreté rurale, et évalué si la sensibilité de parentage dans les quatre premières années de vie prédisaient l'internalisation de symptômes émotionnels de la part de l'enfant (comme l'anxiété et la dépression) de la maternelle au CM2 (ou 5ème au Québec) et si le fonctionnement exécutif précoce de l'enfant servait de médiateur à la relation. Les analyses causales ont indiqué que l'observation d'un parentage sensible prédisait une baisse des rapports faits par les enseignants de symptômes émotionnels négatifs de la part des enfants et prédisaient moins de symptômes émotionnels négatifs au CM2 (5ème au Québec). De plus, bien que la performance du fonctionnement exécutif n'a pas médié les changements dans les symptômes au fil du temps, le fonctionnement exécutif a médié la relation entre le parentage sensible et les symptômes au CM2 (5ème au Québec), suggérant que le fonctionnement exécutif est un mécanisme par lequel le parentage sensible précoce sert de tampon au développement émotionnel à long terme. Les résultats mettent en lumière l'importance du parentage précoce et du fonctionnement exécutif dans le développement de symptômes d'anxiété et de dépression et suggèrent des cibles potentielles pour une intervention trans-diagnostique.

[Anxiety and Depression in Transition - Desiderata for Improved Care and Research: Results of the Joint Task Force Transition of DGPPN and DGKJP]. / Angst und Depression in der Transition ­ Desiderate für eine verbesserte Versorgung und Forschung: Ergebnisse der gemeinsamen Task-Force Transition von DGPPN und DGKJP.

Anxiety and Depression in Transition - Desiderata for Improved Care and Research: Results of the Joint Task Force Transition of DGPPN and DGKJP Abstract. Affective disorders (e. g., anxiety, depression) frequently begin during adolescence. Yet therapeutic approaches during adolescence differ in some respects from those employed during adulthood. During the transition from adolescence to adulthood, there is a high risk of discontinuation of therapeutic treatment, which may consequently affect integration in employment. There is a need for age-specific therapeutic strategies that address the relevant issues of adolescents as well as the presently unmet needs in research and treatment for this specific population.

[Dental anxiety in preschool children: How helpful are behavioral control management strategies?] / Angst vor medizinischen Untersuchungen am Beispiel der Zahnbehandlungsangst: Wie hilfreich ist der Einsatz verhaltenstherapeutischer Techniken bei Vorschulkindern?

Dental anxiety in preschool children: How helpful are behavioral control management strategies? Abstract. Objective: Dental anxiety is a frequent problem in the dental treatment of young children. Control management methods are widely used in pediatric dental care as coping strategies. This study compares two control management strategies regarding their reduction of dental anxiety and treatment success. Method: A group of 60 preschool children with known dental fear in their medical history underwent professional dental cleaning in which the Tell-Show-Do Method (TSDM) was applied. Patients were randomized into two groups according to the controlling method employed: (1) limited controlling method (L-K) and (2) standardized controlling method (S-K). The efficacy of the two control methods was tested using pulse rate as an objective measure of anxiety and self-rating as a subjective indicator. Results: Both the S-K and the L-K condition showed a significant reduction in pulse rate, and there was no difference in physiological arousal and treatment success. However, independent of the group disposition, there was a noticeable increase in pulse rate in children after TSDM. Conclusion: The results of this study indicate that even limited options for controlling dental treatment do not lead to greater burdens on the children in question with dental anxiety. However, further studies are necessary to investigate the use of control methods independent of TSDM.

Motivated emotion and the rally around the flag effect: liberals are motivated to feel collective angst (like conservatives) when faced with existential threat.

A careful look at societies facing threat reveals a unique phenomenon in which liberals and conservatives react emotionally and attitudinally in a similar manner, rallying around the conservative flag. Previous research suggests that this rally effect is the result of liberals shifting in their attitudes and emotional responses toward the conservative end. Whereas theories of motivated social cognition provide a motivation-based account of cognitive processes (i.e. attitude shift), it remains unclear whether emotional shifts are, in fact, also a motivation-based process. Herein, we propose that under threat, liberals are motivated to feel existential concern about their group's future vitality (i.e. collective angst) to the same extent as conservatives, because this group-based emotion elicits support for ingroup protective action. Within the context of the Palestinian-Israeli conflict, we tested and found support for this hypothesis both inside (Study 1) and outside (Study 2) the laboratory. We did so using a behavioural index of motivation to experience collective angst. We discuss the implications of our findings for understanding motivated emotion regulation in the context of intergroup threat.

[Effectiveness of Psychoanalytic Psychotherapy for Children and Adolescents with Severe Anxiety Psychopathology in a Naturalistic Treatment Setting]. / Wirksamkeit analytischer Psychotherapie bei Kindern und Jugendlichen mit klinischen Angstsyndromen im naturalistischen Behandlungssetting.

Effectiveness of Psychoanalytic Psychotherapy for Children and Adolescents with Severe Anxiety Psychopathology in a Naturalistic Treatment Setting The aim of the study was to evaluate naturalistic out-patient psychoanalytic youth psychotherapy in Germany. The study was a partly controlled effectiveness trial. While the first treatment interval (25 sessions, 6.13 months) was compared with a wait-list control group (5 supportive sessions, 2.94 months), the effects of long-term psychoanalytical treatment were analyzed using a time-series design. 86 children and adolescents (aged 4 to 21 years) and their parents who entered psychoanalytic therapy in private practices participated in this study. The wait-list control group comprised 35 patients. Questionnaires were administered at the beginning and the end of treatment, as well as 6 and 12 month follow-up (FU). Patients received on average 94.04 therapy sessions (range 8 to 300) over 25.70 months. Data analyses were carried out with multilevel mixed linear models on the intention-to-treat (ITT) sample. The patients in the intervention group reported moderate symptom improvements at the end of therapy (d = .57), these effects are stable at the 1-year follow-up and increase from the patient perspective (d = .80). When comparing the first therapy interval with the (minimal treatment) wait-list control group, both groups improved significantly with small effect sizes and no significant group differences. The results suggest that long-term psychoanalytic therapy is successful in alleviating anxiety pathology and improving quality of life for youth with anxiety disorders, and that improvements remain stable across a 1-year follow-up period.

DISORGANIZATION, FEAR AND ATTACHMENT: WORKING TOWARDS CLARIFICATION.

In 1990, M. Main and J. Solomon introduced the procedures for coding a new "disorganized" infant attachment classification for the Ainsworth Strange Situation procedure (M.D.S. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978). This classification has received a high degree of interest, both from researchers and from child welfare and clinical practitioners. Disorganized attachment has primarily been understood through the lens of E. Hesse and M. Main's concept of "fright without solution," taken to mean that an infant experiences a conflict between a desire to approach and flee from a frightening parent when confronted by the Strange Situation. Yet, looking back, it can be observed that the way Hesse and Main's texts were formulated and read has generated confusion; there have been repeated calls in recent years for renewed theory and clarification about the relationship between disorganization and fear. Responding to these calls, this article revisits the texts that introduced the idea of fright without solution, clarifying their claims through articulating more precisely the different meanings of the term fear. This clarified account will then be applied to consideration of pathways to infant disorganized behaviors.

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS.

Symptoms of depression negatively impact on mother-infant relationships and child outcomes. We evaluated a novel, 10-session mother-infant therapeutic playgroup-Community HUGS (CHUGS)-which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother-infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait-list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self-Efficacy subscale; J. Gibaud-Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self-efficacy, p < .001, all showed improvements, as did observer-rated mother-infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait-list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self-efficacy, depression, anxiety, stress, and mother-infant interactions that supported the program's acceptability and the utility of further rollout.

DOES FATHERS' PRENATAL MENTAL HEALTH BEAR A RELATIONSHIP TO PARENTING STRESS AT 6 MONTHS?

This study aimed to explore fathers' mental health and retrospectively reported adverse childhood experiences during pregnancy, as well as various pathways predicting self-reported stress at 6 months' postpartum as assessed by the Parenting Stress Index (PSI; R.R. Abidin, ). A total of 835 fathers contributed data to the study. Data collection comprised five time points during pregnancy and one at 6 months' postpartum. The main analyses were performed using linear regression and path analyses. First, linear regression analyses showed that paternal anxiety symptoms during pregnancy predicted stress scores in the PSI child domain at 6 months (coefficient = 0.36). Second, path analyses showed that depressive symptoms during pregnancy predicted parenting stress in the child domain, mediated by spousal disharmony at 6 months' postpartum (coefficient = 0.77). Third, adverse childhood experiences scores predicted parenting stress in the child domain by two different pathways: one mediated by anxiety symptoms in pregnancy (coefficient = 0.29) and the other by depressive symptoms in pregnancy and experienced spousal disharmony at 6 months' postpartum (coefficient = 0.77). The findings suggest that fathers' symptoms of anxiety and depression during pregnancy as well as adverse childhood experiences predict paternal stress and a negative perception of their children's behavior at 6 months' postpartum.

[Anxiety during the chronic critical illness in the intensive care unit - an interpretive phenomenological study]. / Angst während der chronisch kritischen Erkrankung auf der Intensivstation ­ eine interpretierende phänomenologische Studie.

Anxiety during the chronic critical illness in the intensive care unit - an interpretive phenomenological study Abstract. BACKGROUND: Patients with a chronic critical illness (CCI) are persons who are dependent on life-sustaining therapies in the intensive care unit (ICU) for an extended period of time following a life-threatening, acute illness. In the ICU they are exposed to numerous physical and psychological stressors. Anxiety, one of the distressing symptoms, has received little attention. AIM: This study aims to examine anxiety in adult patients who have developed CCI while treated in an ICU to further understand this phenomenon. METHOD: An interpretive phenomenological approach was taken. Using an iterative process, data from guided interviews with seven participants were analysed. RESULTS: The anxiety experienced by the patients with CCI fluctuated with the level of consciousness: anxiety in another reality, anxiety caused by nightmares, anxiety at first awakening and anxiety during wakeful periods. Anxiety was often accompanied by feelings of powerlessness, being lost, insecurity, helplessness and uncertainty. CONCLUSIONS: The results of the study suggest that health care professionals caring for patients, especially nurses, may influence anxiety experienced by patients with CCI. Nurses who are able to recognize anxiety in patients with CCI have a better chance of caring for them in a sensitive manner.

MATERNAL INTERACTION QUALITY MODERATES EFFECTS OF PRENATAL MATERNAL EMOTIONAL SYMPTOMS ON GIRLS' INTERNALIZING PROBLEMS.

The role of mother-infant interaction quality is studied in the relation between prenatal maternal emotional symptoms and child behavioral problems. Healthy pregnant, Dutch women (N = 96, M = 31.6, SD = 3.3) were allocated to the "exposed group" (n = 46), consisting of mothers with high levels of prenatal feelings of anxiety and depression, or the "low-exposed group" (n = 50), consisting of mothers with normal levels of depressive or anxious symptoms during pregnancy. When the children (49 girls, 47 boys) were 23 to 60 months of age (M = 39.0, SD = 9.6), parents completed the Child Behavior Checklist (T.M. Achenbach & L.A. Rescorla, ), and mother-child interaction quality during a home visit was rated using the Emotional Availability Scales. There were no differences in mother-child interaction quality between the prenatally exposed and low-exposed groups. Girls exposed to high prenatal emotional symptoms showed more internalizing problems, if maternal interaction quality was less optimal. No significant effects were found for boys.

EXAMINING PARENTS' ROMANTIC ATTACHMENT STYLES AND DEPRESSIVE AND ANXIETY SYMPTOMS AS PREDICTORS OF CAREGIVING EXPERIENCES.

Evidence has suggested that parental romantic attachment style and depressive and anxiety symptoms are related to experiences of caregiving (Creswell, Apetroaia, Murray, & Cooper, 2013; Jones, Cassidy, & Shaver, 2014; Lovejoy, Graczyk, O'Hare, & Neuman, 2000), but more research is necessary to clarify the nature of these relations, particularly in the context of attachment-salient events such as reunions. In a cross-sectional study of 150 parents of children ages 1 to 3 years, we assessed participants' attachment styles (self-reported anxiety and avoidance) and depressive and anxiety symptoms. Participants generated a narrative describing their most recent reunion with their child, which we coded for caregiving outcomes of negative emotion and secure base script content. Attachment style and depressive and anxiety symptoms separately predicted each caregiving outcome. Depressive and anxiety symptoms mediated the associations between attachment style and caregiving outcomes. These results suggest that parental attachment insecurity and depressive and anxiety symptoms contribute to negative emotion and reduced secure base script content. Further, depressive and anxiety symptomatology partially accounts for the relation between attachment insecurity and caregiving outcomes, suggesting that parental mental health is a critical point for intervention.

ANXIETY AND DEPRESSION DURING PREGNANCY AND TEMPERAMENT IN EARLY INFANCY: FINDINGS FROM A MULTI-ETHNIC, ASIAN, PROSPECTIVE BIRTH COHORT STUDY.

Maternal antenatal mood is associated with negative infant temperament. This link has not been substantiated in Asian populations. We evaluated the association between antenatal maternal mood and infant temperament among Asian mother-infant pairs. Antenatal maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (J. Cox, J. Holden, & R. Sagovsky, 1987) and the State-Trait Anxiety Inventory (C. Spielberger, R. Gorsuch, R. Lushene, P. Vagg, & G. Jacobs, 1983), respectively, at 26 weeks of pregnancy and 3 months' postnatally. Infant temperament was evaluated with the Early Infant Temperament Questionnaire (B. Medoff-Cooper, W.B. Carey, & S.C. McDevitt, 1993) at 3 months. Factor analysis was performed to extract culturally relevant categories of temperamental traits. Linear regression was performed to examine the influences of antenatal maternal mood on the factor-model-derived infant temperament. Of the 609 mothers, 11% met risk criteria for depression, 17% for state-anxiety, and 19% for trait-anxiety during pregnancy. Factor analysis yielded three infant temperament factors: Emotionality and Attentional Regulation, Sensory Reactivity, and Regularity and Motor Expression, Cronbach's αs = 0.613, 0.712, and 0.752, respectively. Maternal antenatal state-anxiety, p < .001, and trait anxiety, p = .005, were associated with negative emotionality and poor attentional regulation, especially among Chinese, whereas depression was not, p = .090. There was an association between maternal antenatal anxiety and negative infant temperamental traits in this Asian sample.